The Associations between Racial Disparities, Health Insurance, and the Use of Amputation as Treatment for Malignant Primary Bone Neoplasms in the US: A Retrospective Analysis from 1998 to 2016

Int J Environ Res Public Health. 2022 May 22;19(10):6289. doi: 10.3390/ijerph19106289.

Abstract

Primary bone neoplasms (PBNs) represent less than 1% of diagnosed cancers each year. Significant treatment disparities exist between racial and ethnic groups. We investigated patients with PBNs to determine an association between race/ethnicity and procedure-type selection. A non-concurrent cohort study was conducted using the SEER database. Patients diagnosed with PBNs between 1998 and 2016 were included (n = 5091). Patients were classified into three racial groups (Black, White and Asian Pacific Islanders) and were assessed by procedure-type received. The outcome was amputation. Race was not associated with increased amputation incidence. Hispanic patients had a 40% increased likelihood of amputation (OR 1.4; 95% CI 1.2-1.6). Insurance status was an independent predictor of procedure selection. Uninsured patients were 70% more likely to receive amputation than insured patients (OR 1.7; 95% CI 1.1-2.8). We recommend provider awareness of patients less likely to seek regular healthcare in the context of PBNs.

Keywords: amputation; limb salvage; osteosarcoma; primary bone neoplasm; race; racial disparity.

MeSH terms

  • Amputation, Surgical
  • Bone Neoplasms* / surgery
  • Cohort Studies
  • Humans
  • Insurance, Health*
  • Retrospective Studies

Grants and funding

This research received no external funding.